A Tricky Problem-Cocaine Abuse

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About This Module

Topics: Human health, epidemiology, drug abuse, cocaine abuse, addiction, neurological addiction factors, withdrawal, genetic vs environmental factors of substance abuse, social and emotional consequences to drug addiction

Grade levels: 9-12

Teacher Note: There are three scenarios included in “A Tricky Situation” PBL modules. Each involves a different drug type (alcohol, cocaine, and opioids) and a slightly different scenario, but all have the same tasks. If you divide your class into multiple student teams each having a different type of drug abuse, your class will learn about issues and health effects of different drugs, but will have the same tasks. Work is equitable throughout the class teams and can be assessed with the same rubric.

You may want to assign the specific type of drug based on what type is more prevalent in your community.

Overview

Students plan carefully to talk to a friend about his cocaine drug abuse. They investigate the physical, social, emotional, and mental health effects of cocaine abuse as well as the genetic and environmental factors that influence substance abuse.

Learning Objectives

To better understand the complex problems of cocaine abuse, students should be able to:

  • Describe the health effects of cocaine abuse on organs of the body.
  • Explain behavior indications that could point to substance abuse.
  • Compare and contrast genetic and environmental factors affecting drug abuse.
  • Describe issues surrounding the difficulties of talking with someone about his drug abuse.
  • Explain treatment options for substance abuse addictions.
  • Describe the social, emotional and mental health effects of cocaine abuse on the user and his family and friends.
Standards

Next Generation Science Standards

Standards Aligned to PBL Modules

Scenario (with possible answers)

You’re having a pretty chill evening. You‘re sprawled in the recliner rocker in your living room having a snack and working on some homework. Your parents have the nightly news on TV and you aren’t paying much attention to it until a news story about the quarterback for your favorite football team comes on.

A football player runs on a field with a football“Joe Sandicheck, quarterback for the Boston Chargers, checked into a drug rehab program today as part of the conditions of his sentencing on drug possession. Sandicheck, MVP of the last 3 Superbowls, led the Chargers to their 37-24 win over the Austin Rebels last January only to be arrested that same night on possession of cocaine. It was the
third conviction on drug charges for Sandicheck. He was also charged with resisting arrest, impeding a police investigation, assaulting a police officer, and destruction of public property.

In exchange for reduced jail time, Sandicheck agreed to enter into a comprehensive rehab program and to perform 1,000 hours of community service.

Friends are hoping that Sandicheck can turn his life around. Several friends, who wish to remain anonymous, describe his steady downfall due to cocaine use. His addiction came to light after Sandicheck became increasingly anxious, restless, and sometimes paranoid.  Relationships in his life suffered as he and his wife were divorced last fall. She has custody of their 3 children.

Health issues led to Sandicheck missing 4 games last season as rumors of a drug problem surfaced.”

A young male sits on a benchAs you listen to the report, you realize that Joe Sandicheck’s problems—minus the arrest and the divorce—sound an awful lot like what is happening to a friend of yours. You have already talked with a few of your friends about Jason and they had noticed the same things.

Jason just isn’t the same as he used to be. He’s either exhausted or hyper. If he’s tired, he says he didn’t sleep well, and if he’s hyper, he just had too much coffee. You never see him drink coffee at lunch—he doesn’t even eat his lunch.

He backs out of plans or just doesn’t show up without telling anyone. He picks fights and starts arguments and his girlfriend just dumped him because she couldn’t stand arguing all the time.  He kept accusing her of cheating on him and she could never convince him that she wasn’t.  She said her parents hassled her because he looks like such a bum all the time.

person sits by a street in the darkHe always seems sick now—he just says that he has a cold.  Who has a cold all the time? And who loses all that weight from having a cold?

Then, there was that science class when Jason said his cold was so bad that his nose wouldn’t stop running—stuff just poured constantly from his nose. He kept asking to get up and get more of those brown scratchy lab paper towels.  Half-way through the period his nose was red and raw from that scratchy paper—he actually winced every time he had to wipe his nose. The teacher started giving him suspicious looks and we all started wondering what was going on.

The news report continued and you really started to worry. Friends of Joe Sandicheck said they knew about the drug problem but didn’t want to say anything about it that would get him in trouble.

Charger quarterback, Robert Handison commented, “The whole team supports
Joe 100%. It’s just a shame that it has come to this. We hope he can
return to the team when he gets out of jail, but we still don’t know that yet.”

You wonder how they can support someone 100%, but do nothing to help. Maybe you should look into Jason’s symptoms and talk to him. If he really is using cocaine, he must be using it often. You know you have to be ready with information or Jason will just get ticked off and deny everything. You need a plan to talk to Jason that will help him.

You go to friends for help on this. Together, you and your friends work on the problem.

Your Tasks—Part I. Cocaine Abuse Effects

  • Decide on a plan that you would use to talk to someone you suspect of having a problem with cocaine abuse. Be specific with your ideas.
  • Make a presentation for your class that will provide information about the effects of this type of cocaine abuse on the body.
  • To be able to explain the health issues that surround this drug abuse as well as the social and emotional consequences to an addict’s life.
  • Research this drug abuse to prepare for your presentation. You can use any kind of presentation aid available to you, including PowerPoint. (Your teacher may have other requirements.)
  • Be prepared to answer the questions presented in this module.
  • Be prepared to answer the questions from your classmates or teacher as they play the roles of other students or teachers at the school who will be interested in finding out about drug abuse and how to cope with it.
  • Be prepared with statistics to back up your presentation. Epidemiologists track trends, use, increases and decreases, locations, persons, age, and many other factors as they study the incidence of drug abuse. These statistics may be a powerful tool to help students and adults understand the scope of the problem.
  • Based on the results of your classroom presentation, evaluate how effective your plan was in helping students understand the challenges of helping someone who abuses this drug. What could you have done differently? What else could you do that may help?

Guiding Questions

  1. What are the effects of cocaine abuse? Explain the effects of cocaine on the various body systems. Be sure to list short-term and long-term effects.

Cocaine is a fast-acting drug; how fast depends on the method with which it is used. How long the effects last is also dependent on the method with which it is used.

Short-term effects include feelings of intense euphoria, increased energy, an inflated sense of self-esteem and a decreased need for sleep. Other side effects include feelings of restlessness, irritability, anxiety, panic, and paranoia.

Long-term effects include addiction, tremors, muscle twitches, constricted blood vessels, vertigo, dilated pupils, increase heart rate, increased blood pressure, increased temperature, and decreased sexual function.

Other effects include extreme fatigue, constant headaches, abdominal pain, nosebleeds, weight loss, susceptibility to infectious diseases from unsafe injection use, heart attacks, vascular disease, and seizures.

Overdoses of cocaine can result in cardiac arrest, strokes, respiratory arrest, and sudden death.

 2. List the physical, behavioral, and social symptoms of the drug’s use that Jason was displaying.

Jason’s symptoms sounded a lot like the football player’s situation. The football player had become increasingly anxious, restless, and sometimes paranoid. His relationships had suffered and his job performance was poor.

Jason’s friends noticed that he was just not the same as he used to be. He was now either exhausted or hyper and friends rarely saw him eat lunch. He doesn’t show up for planned activities, he picks arguments with people, and his girlfriend broke up with him because he accused her of cheating on him after she assured him that she had not.

Jason always seems like he has a cold. His nose runs all the time. Snorting cocaine breaks down mucus membranes in the nose and membranes become irritated and inflamed. Short-term effects include sneezing, runny nose, nasal congestion and nosebleeds.  Long-term damage can cause sores to form and the nasal septum to perforate.

  1. What kinds of treatment are available to help someone overcome addiction to this drug?

 In-patient and out-patient rehabilitation programs:

 Jason will have to attend rehabilitation counseling for a lengthy period of time. There is no one answer for everyone for length of time for rehabilitation. Addiction specialists consider many factors for each patient before they create a plan for treatment. These factors include how strong the addiction is, how much drug they have been using, and how long they have been addicts.

  • Average stays for inpatient rehab is from 30-90 days. Addicts are required to stay in a treatment facility during their rehabilitation.
  • Long-term cocaine rehabilitation can take from 3 months to a year or more.
  • Outpatient cocaine rehabilitation is a longer procedure, but can be more convenient for the patient because they do not have to reside in a facility. The patient has a variety of therapies several times per week for 10-16 weeks. Some patients require longer periods of treatment.

There are a variety of behavioral therapy approaches that have been somewhat successful in treating cocaine addictions. Interventions that include a system of motivational rewards for continuing to be cocaine-free (monitored by urine drug tests) have been shown to be effective in keeping people from relapsing for longer than other therapies. Other therapies focus on teaching patients to better recognize situations that may trigger cocaine use relapse.

A combination of behavioral therapies and medications that can be used to lessen withdrawal symptoms can be used in both in-patient and out-patient settings.

Jason will also have to be diligent in attending periodic counseling sessions if he manages to stop using drugs. According to research studies, 24% of people who stop using drugs relapse into within a year following treatment.

  4. How are you going to approach Jason about his drug use?

What are you going to say to him? What can Jason expect if he continues this drug use? Draft all the points of the talk you and your friends will have with him and be ready to present how you will approach him to the class. Be specific.

    Other students may have questions or comments about your presentation.  Be prepared to talk about why you think your approach will work and back up your conclusions with specific examples.

Teacher Note: Be sure that your students know that it is always better to have a parent/guardian or other adult with them if they are going to talk to someone about a possible drug abuse problem. The person may not react well and it could be a potentially harmful situation.

Your students will have different approaches. Experts list the following tips for discussing cocaine (or any drug) abuse with a person abusing cocaine. You may want to discuss these points with your students.

  • It is very difficult to approach a person and talk to him/her about his/her problem with illegal drugs. .
  • It is important that you plan what you want to say to him when you have that talk. Pick a time when you know he is not high. Let close friends and family members know about the problem and that you are going to try to talk to him.
  • Be specific about what you think the problem is and what led you to your conclusion. Try not to use language that will make the person feel defensive. Calling him a drug addict may not help him accept his problem.
  • Listen to his response. Be fair, compassionate, and ready to help.
  • Find out in advance what options are available to help him. Have resources (local programs on addiction, support groups) on hand to give to him.
  • Let him know that you will be supportive of his efforts to quit cocaine abuse, but you will not keep his secret or otherwise make it easier for him to keep using cocaine. You won’t promise not to tell anyone, you won’t buy him cocaine, meet with his dealer, you won’t use with him.
  1. Is Jason a drug addict? Defend your opinion.

Answers will vary, but should consider the information students found when they researched alcohol abuse for this scenario.

 Part II—Genetics vs the Environment  

A model of DNA's double helix structure
A model of DNA’s double helix structure

When you talked to one of your friends about Jason she commented that Jason probably wasn’t going to take the conversation well, considering the mood he’s been in lately. She also worries that Jason is in real trouble. She tells you that Jason’s brother smokes and drinks a lot and he’s wasted every weekend!

You start to wonder if this has anything to do with Jason’s problem.  You just heard about a study being done to find out if addiction is inherited or if it is more of an environmental issue—if something in your environment leads to a greater risk of addictive behaviors. If you knew more about this, you might be able to help Jason even more.  You think it might be a family issue since none of Jason’s friends do drugs.  He doesn’t hang out with drug users, so how else did he get into this?

Tasks:

  1. Investigate the genetic and environmental links to addiction. What conclusions do you draw from your research?

Scientific studies have suggested that children who have family members who have drug addictions are more likely to try drugs and may develop a drug addiction.

But, having family members who have had an addiction problem is not a guarantee the children with either use drugs or become addicted. Studies have shown that most children of parents who abuse drugs do not develop alcoholism or addiction themselves.

 In this case, do you think Jason’s drug use is inherited or has it been influenced by his environment? Why do you think that?

Answers will vary.

You may want to discuss the following information with your students:

Scientific research has concluded that addictions are complex diseases that have links to both genetic and environmental factors, especially in the initial use of drugs. Family history studies, adoption statistics, and twin studies have shown that an individual’s risk is related to heredity.

The heritability differs with the type of drug abuse. It also differs with age. In early adolescence, the initial use of tobacco, alcohol, and marijuana are more related to family or social factors; genetic factors become a greater influence in young and middle adulthood.

Of course, incidence of addictive behaviors and drug abuse are dependent on the availability of the drug. Availability is great affected by culture, social policies, religion, and economic status.

Stress to your students that having a family member with an addiction problem does not mean that they will develop an addiction problem.

Part III—Risky behaviors

“Did you hear about Jason?” asked Shandra when she called later that week.   “He had a heart attack last night!  He was driving home from the game when it happened!  He’s in intensive care at the Yorktown Med Center. They’re not sure he’ll make it! We were going to talk to him today after school! And we just found out that cardiac arrest can happen with cocaine abuse. What are we going to do?”

Guiding Questions:

  1. Drug use is also tied to a lot of other risky behaviors and consequences. Cite some of these behaviors and consequences and explain how other risks are associated with drug use.

Most risky behaviors are associated with the impaired judgement that results from cocaine (or any drug) use. These include:

  • social problems
  • morbidity (disease)
  • mortality (death)
  • injuries
  • pregnancy
  • contracting HIV/AIDS and other infectious diseases
  • other drug use
  • violence
  • suicide
  • car accidents
  • homicides
  • cancer
  1. Aside from the expected symptoms, what other issues surround using this drug?

Adding substances to the cocaine, contaminants, and unknown purity and strength of the illegal street drug

  1. What will be the some of the consequences of Jason’s cocaine abuse? If he survives the heart attack, list the consequences to all aspects of his life now and in his future.

Jason will have to attend rehabilitation counseling for a lengthy period of time. There is no one answer for everyone for length of time for rehabilitation. Addiction specialists consider many factors for each patient before they create a plan for treatment. These factors include how strong the addiction is, how much drug they have been using, and how long they have been addicts.

  • Average stays for inpatient rehab is from 30-90 days. Addicts are required to stay in a treatment facility during their rehabilitation.
  • Long-term cocaine rehabilitation can take from 3 months to a year or more.
  • Outpatient cocaine rehabilitation is a longer procedure, but can be more convenient for the patient because they do not have to reside in a facility. The patient has a variety of therapies several times per week for 10-16 weeks. Some patients require longer periods of treatment.

Jason will also have to be diligent in attending periodic counseling sessions if he manages to stop using drugs. According to research studies, 24% of people who stop using drugs relapse within a year following treatment.

Jason may have continued health problems from damage done to his body during his drug usage. Long-term effects may put him at a disadvantage for some opportunities he may have had otherwise. Cocaine damages many organs of the body. Heart attacks, strokes, inflammation of heart muscle, neurological problems such as intra-cerebral hemorrhage (bleeding in the brain) can occur after the person quits using cocaine. Cognitive functions are impaired; the person has a decreased ability to make decisions, decreased memory capabilities, and poor impulse control. Performing motor tasks is more difficult. All these health consequences impact the addict’s future choices and opportunities.

Cocaine use puts the user at risk for other life-threatening conditions such as HIV and hepatitis.

Even if he manages to control his drug addiction in the future, a history of drug use may put him at a disadvantage socially and professionally.

Jason will have to be careful to avoid associations with people who may lead him back to drug use. He may have to give up friendships with people who cannot keep off drugs. (Relapses can often be traced to a “trigger”. The addict sees people who did drugs with him or places where he bought drugs and these events trigger a relapse to drug use.)

Jason’s past drug use may prevent him from getting jobs in the future. A record of drug abuse, or worse, a criminal record related to drug abuse, could make finding a job more difficult. The Americans with Disabilities ACT (ADA) protects individuals in recovery from being discriminated in the workplace, but some employers may be hesitant to hire someone who is at risk for relapse into drug abuse.

However, it is much better for Jason to seek treatment and show that he is in recovery than to continue to put himself and others at risk. He will do better in all aspects of his life if he can recover and stay off drugs.

 

Sample Rubric

Information about constructing and implementing rubrics for problem-based learning strategies can be found in Developing Rubrics in the Teacher Professional Development section.

Extensions

Call local treatment centers and support groups and ask a counselor to talk to your class about drug addiction issues.

If you cannot find a local treatment center or support group, the U.S. Department of Health & Human Services (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) has a national helpline that provides a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish). They provide information about local treatment facilities, support groups, and community-based organizations and you can then call the local groups to contact an addiction specialist that may talk to your class.

► Invite your county or district public health officer or an epidemiologist from a local university (or both) to talk to your classes about how public health concerning drug addiction is monitored in your area.

► If you haven’t used all the scenarios for different drug types included in the A Tricky Situation module, assign student teams a different drug type. They will probably be able to move more quickly through the Tasks and Guiding Questions since they have worked through one drug type, so you will not have to use as much class time for the second scenario.

►Watch the PBS NOVA documentary “Addiction” with your class:  https://www.pbs.org/wgbh/nova/video/addiction

The documentary delves into the complex issue of drug addiction by profiling several people who became addicted to drugs. Although it deals with opioid abuse, some of the issues surrounding the abuse apply to any drug addiction.

The patients are diverse: a coal miner who was in a traumatic mine accident, a young student active in sports and school, a teen from a successful, caring family, and a young mother who loses her children due to her drug abuse.

Through the stories of these people, the documentary explains the mechanism of addiction, how drugs change the brain, and how those changes make continued recovery difficult. It also explains how the epidemic of drug abuse continues to grow in the United States. How did it begin? Why is it so difficult to contain? What can be done to reduce the ever-increasing trend?

A student study guide for this documentary is included in the module. A complete teacher guide with answers to questions is in the student guide are in the Teachers Pages section on the PDC site.

► If possible, display your students’ work on their drug awareness project around the school.  If you had them make a poster, do a survey, or create a fact sheet, they could be displayed in the halls, the media library, or the school cafeteria.

► Local newspapers and TV stations are always looking for community news. Contact your local newspaper and TV stations about your students’ work on drug awareness and the health effects of drug abuse. Students can be interviewed about their projects and more people will become aware of community resources and important efforts to educate students about the dangers of drug use.

► Organize a school program or parent/community night that delivers the drug awareness program in the scenario in this module. Student groups could present their research on the type of drug abuse covered in their module. Each scenario in the “A Tricky Problem” package covers a different type of drug abuse along with the resources, effects and consequences of drug abuse, and the approach they developed to talk to their friend or family member.

Additional Resources

Additional resources about drugs and drug abuse can be found:

at the cocaine abuse scenario page at:
http://www.pandemsim.com/pdc/a-tricky-problem-cocaine/

at the direct link to Internet Resources—Cocaine Abuse:
http://www.pandemsim.com/pdc/internet-resources-cocaine-abuse/

at the direct link to Internet Resources—Drug Abuse
http://www.pandemsim.com/pdc/internet-resources-drug-abuse/